MERS Virus- Health Camp Diaries XXXI

MERS Virus in “10 Points”: Updated Summary Information: Risks and Suggestions

MERS‐CoV (Middle East Respiratory Syndrome Coronavirus)

In this Article, you will find updated summary information about MERS virus, its prevalence, modes of transmission and protection from infection. MERS virus is from the same family with lethal SARS virus. This virus, which is 3 times deadlier than SARS, is of particular importance to our country due to health tourism and pilgrimage (haj) as well as employment of tens of thousands of Turkish workers in the companies located in the region.

1. In its evaluation, World Health Organization (WHO) stated that 339 MERS cases had been observed since 2012 and 102 people died.
2. The countries where these cases were mainly observed include, Saudi Arabia, Oman, Qatar, Jordan, Kuwait and United Arab Emirates. The virus has also been found in persons who visited the region and returned to their home countries, including France, Germany, Italia, UK, Greece, Malaysia, Philippines, Tunisia and lastly USA (1)

The first deadly case was reported in Jeddah, Saudi Arabia. The first virus isolation was made by Egyptian virologist Dr. Ali Mohamed Zaki in June 2012.

3. The number of the cases reaches to highest level especially in March-April period. According to the information available, most of the cases are secondary infection. Only ¼ of the cases are primary cases while remaining ¾ is secondary.

Infection from other humans has not been observed yet. Of the cases diagnosed, 67% the patients are male. The average age of the patients is 52.

4. The studies reveal that the infected persons got the virus from single humped young camels. The other animals on which research goes on include bats and goats. The virus does not have characteristic symptoms.

The disease of the virus leads to symptoms similar to common cold. It starts with fever , coughing and difficulty in breathing. It does not have a specific cure or vaccine.

5. Workers, migrants, tourists and pilgrims who came from Saudi Arabia and U.A.E. and who had any contact with above-mentioned animals constitute the group with the highest level of risk.
6. The people with diabetes, kidney, and chronic lung diseases, immunsuprese (low immunity) problems; meat market workers who had been present in the environments where camels exist, ,people visiting camel farms; those who eat meat food contacted by raw milk or secretions of these animals, those who do not pay attention to hand hygiene, health sector employees and officials are reported as persons and occupational groups most sensitive to infection.
7. MERS virus, which is from Corona virus family just like SARS (Severe Acute Respiratory Syndrome , diversly from SARS, causes renal failure.

As you may remember, 8 thousand 300 people were infected with SARS virus during the epidemic observed in China in 2003. And 800 of them died.

8. The characteristics of MERS which make it more dangerous is related to the facts that it threatens crowded hospital environments and causes renal failure. Besides Saudi Arabia hosts 2.000.000 pilgrims visiting Saudi Arabia during the haj season (and just 750.000 visitors from Turkey during Umrah season) and most of the people visiting this country prefer airways, which is very crowded, causing close contact among passengers.
9. How to get protected from infection: It is necessary to pay great attention to hand and face hygiene and contact especially at connection airports in which people coming from these countries blend into crowd. You should avoid handshaking, kissing, hugging, not having close contact with other people while waiting in line.. You should clean your hands, face with anti-septic solutions and should not clean your nose and your mouth, throat without first cleaning your hands. Avoid contacting others, use handkerchief while sneezing. And use wet towel while touching ATMs, kiosks, door handles of toilets in such locations.
10. According to the Economist, virologist Dr. Ali Mohamed Zaki was fired from the hospital that he works for because he had sent the first findings and the samples of the virus to Mr. Fouchier, who later showed the genetic configuration of the varies and patented this information.

Last words: It can be stated that Turkey is one of the first countries that should take emergency measures immediately given her geographic proximity to the region, her pilgrims (Haj quota for Turkey is 74,000 and number of applications is close to 1,200,000.) her citizens working in the countries in the region, and ever increasing potential of demand for health tourism from this region..

An Joint Emergency Action Plan for Protection to be prepared by the Ministry of Health and the Ministry of Transportation (in-flight and at the airports) is one of the urgent steps that should be taken and the people should be informed of the risks with public service ads and billboards.

Besides, in terms of health tourism, it is also critical to inform the hospitals and the health personnel that will have contact with patients coming from neighboring Iraq, especially, from Bagdad, Erbil, and from Gulf Countries about MERS and virusˊ the mode of transmission.

References:

1) http://fox59.com/2014/05/02/first-us-case-of-mers-reported-in-indiana/#axzz30jbKPSYE

2) Memish ZA, et al. Human Infection with MERS Coronavirus after Exposure to Infected Camels, Saudi Arabia, 2013. Emerg Infect Dis, 2014 Jun (Early online release)

3) Alagaili AN, et. al. Middle East Respiratory Syndrome Coronavirus Infection in Dromedary Camels in Saudi Arabia. mBio. 2014. 5(2)